By Steve Kelman

The measles outbreak and the ignorance lobby

The ultrastructural appearance of a single virus particle, or "virion," of measles virus, as seen through a transmission electron micrograph. (CDC)

Possibly because of my own current health problems, I am unusually aware of health news these days, and have been following with interest the recent measles outbreak that began in Disneyland and has now spread to seven other states.

This is not a problem driven by an accident or bad luck. It is not a problem created by government. Instead, media reporting on the outbreak has pinpointed the problem as a movement against vaccination, particularly against measles, launched by a doctor named Andrew Wakefield, who has promoted the idea that the vaccine can cause autism.

Originally, it was possible for a reasonable person to believe Wakefield’s claims, based on a research study published in a medical journal. However, that day is long past. The research was eventually exposed as fraudulent, the published work retracted by the journal that published it, and Wakefield’s medical license taken away.

However, that Wakefield’s work was completely discredited seemed to do nothing to cause his supporters to reconsider. An article recently in the Washington Post noted that Facebook is still "populated by pages like 'Dr. Wakefield's Work Must Continue,'" and there is a website called "We Support Andrew Wakefield," with thousands signing petitions pledging support. This subterranean movement has produced a decline in vaccination rates in states such as California that allow parents to opt out of requirements to vaccinate children.

If only a few kids don’t get vaccinated, the “herd immunity” created by the vast majority who do will tend to protect even the unvaccinated. But when the percentage of unvaccinated increases, a disease can start to spread among them. This is what is happening now.

The problem that measles' reappearance highlights is that there is, sadly, an ignorance lobby in American society, a group of people actively distrustful of evidence and research. The ignorance lobby gets its strength from two underlying cultural phenomena, both highly unfortunate.

One is a variant of anti-elitism, where people blame their problems on some powerful minority that keeps "the people" down. On the left, anti-elitism often takes the form of hostility to the rich, to Wall Street, or to big business. On the right, the elite often blamed is "pointy-headed intellectuals," professors, and universities. (I have often experienced a usually mild version of this in anti-Harvard or anti-university comments on my blog posts here and on other writings.) In this version of anti-elitism, the hostility seems to be that professors or other knowledge experts are trying to use claims about their knowledge to lord over the rest of us.

A second source of fuel for the ignorance lobby is what the historian Richard Hofstadter 50 years ago dubbed the "paranoid style in America politics." By this he meant the conspiracy theories that have haunted American history, starting with the anti-Catholic and anti-immigrant movements of the mid-19th century, where alien elements of various sorts have been blamed for an equally diverse range of problems that people experience. Wakefield's supporters believe that government and university elites are trying to keep knowledge of the danger of the measles vaccine from people, perhaps hoping in some way to profit from that mass deception.

It is particularly weird that opposition to vaccination should be the latest object for the ignorance lobby, because the public health movement and medical research of which vaccination is a part is one of the greatest success stories ever for the ability of knowledge to improve human life. Over the last 150 years, improvements in medicine and public health have added literally decades onto life expectancy and improved the quality of life people are able to enjoy.

Government public health efforts effectively starting with the practical research conduced by Dr. John Snow in London in 1854. Snow simply mapped the cases of cholera in the city, and found that they clustered around certain public water pumps. This correlation helped government officials understand how to stop the epidemic. More broadly, municipal sanitation was an effort led by government to use the results of research and knowledge to improve human life. And its descendant is today's evidence-based government movement to use knowledge to improve the design and content of public policies.

As I wrote in a blog a few months ago on evidence-based government, evidence may not be perfect, but it sure beats most of the alternatives. The sad case of the children who are victims of the ignorance lobby is the latest demonstration of this.